< ![CDATA[

Guidelines for Trauma Quality Improvement Programmes.

Acad Emerg Med. 2010 May 14;

Authors: Mlejnek J, Persyn C

PMID: 20491674 [PubMed - as supplied by publisher]

]]>

< ![CDATA[

The Gap Between Evidence-Based Guidelines and Daily Practice: Cultural, Historical, and Financial Differences: Reply to Letter.

World J Surg. 2010 May 13;

Authors: Holzheimer R

PMID: 20464552 [PubMed - as supplied by publisher]

]]>

Related Articles

< ![CDATA[

Emergency tracheal intubation of severely head-injured children: Changing daily practice after implementation of national guidelines.

Pediatr Crit Care Med. 2010 May 13;

Authors: Martinon C, Duracher C, Blanot S, Escolano S, De Agostini M, Périé-Vintras AC, Orliaguet G, Carli PA, Meyer PG

OBJECTIVE:: To report daily practice of scene emergency tracheal intubation performed by physicians and changes induced by implementation of national guidelines, with special attention to rapid sequence induction (RSI) and control of assisted ventilation. DESIGN:: Observational study. SETTING:: ------. PATIENTS:: A total of 296 children (age, 2-15 yrs old) referred to our center for severe traumatic brain injury (Glasgow Coma Scale score of

PMID: 20473241 [PubMed - as supplied by publisher]

]]>

< ![CDATA[

A systematic review of the evidence for Canada's Physical Activity Guidelines for Adults.

Int J Behav Nutr Phys Act. 2010 May 11;7(1):39

Authors: Warburton DE, Charlesworth S, Ivey A, Nettlefold L, Bredin SS

ABSTRACT: This systematic review examines critically the scientific basis for Canada's Physical Activity Guide for Healthy Active Living for adults. Particular reference is given to the dose-response relationship between physical activity and premature all-cause mortality and seven chronic diseases (cardiovascular disease, stroke, hypertension, colon cancer, breast cancer, type 2 diabetes (diabetes mellitus) and osteoporosis). The strength of the relationship between physical activity and specific health outcomes is evaluated critically. Literature was obtained through searching electronic databases (e.g., MEDLINE, EMBASE), cross-referencing, and through the authors' knowledge of the area. For inclusion in our systematic review articles must have at least 3 levels of physical activity and the concomitant risk for each chronic disease. The quality of included studies was appraised using a modified Downs and Black tool. Through this search we identified a total of 254 articles that met the eligibility criteria related to premature all-cause mortality (N = 70), cardiovascular disease (N = 49), stroke (N = 25), hypertension (N = 12), colon cancer (N = 33), breast cancer (N = 43), type 2 diabetes (N = 20), and osteoporosis (N = 2). Overall, the current literature supports clearly the dose-response relationship between physical activity and the seven chronic conditions identified. Moreover, higher levels of physical activity reduce the risk for premature all-cause mortality. The current Canadian guidelines appear to be appropriate to reduce the risk for the seven chronic conditions identified above and all-cause mortality.

PMID: 20459783 [PubMed - as supplied by publisher]

]]>

Related Articles

< ![CDATA[

Process description and evaluation of Canadian Physical Activity Guidelines development.

Int J Behav Nutr Phys Act. 2010 May 11;7(1):42

Authors: Tremblay MS, Kho ME, Tricco AC, Duggan M

ABSTRACT: BACKGROUND: This paper describes the process used to arrive at recommended physical activity guidelines for Canadian school-aged children and youth (5-17 years), adults (18-64 years) and older adults ([greater than or equal to]65 years). METHODS: The Canadian Society for Exercise Physiology (CSEP) Physical Activity Measurement and Guidelines (PAMG) Steering Committee used the Appraisal of Guidelines for Research Evaluation (AGREE II) Instrument to inform the guideline development process. Fourteen background papers and five systematic reviews were completed. Systematic review authors appraised and synthesized the data, and proposed specific recommendations at an international consensus conference of invited experts and key stakeholders. Independently, an international panel of experts interpreted the evidence from the systematic reviews and developed recommendations following attendance at the Consensus Conference. RESULTS: Using the AGREE II instrument as a guide, specific foci for each of the guidelines were defined and systematic review methodology was used to synthesize the evidence base. The expert panel, CSEP PAMG Steering Committee and methodological consultants reviewed the systematic reviews and Consensus Statement. The expert panel achieved consensus on the level of evidence informing the physical activity guidelines and developed a separate document outlining key recommendations, interpretation of the evidence and justification of each recommendation. CONCLUSION: The CSEP and Public Health Agency of Canada followed a rigorous process to examine the evidence informing potential revisions to existing physical activity guidelines for Canadians. It is believed that this is the first physical activity guideline development process in the world to be guided and assessed by AGREE II and AMSTAR instruments.

PMID: 20459786 [PubMed - as supplied by publisher]

]]>

Related Articles

< ![CDATA[

Best Practice Guidelines on molecular diagnostics in Duchenne/Becker muscular dystrophies.

Neuromuscul Disord. 2010 May 11;

Authors: Abbs S, Tuffery-Giraud S, Bakker E, Ferlini A, Sejersen T, Mueller CR

PMID: 20466545 [PubMed - as supplied by publisher]

]]>

Related Articles

< ![CDATA[

Evaluation of high-definition and conventional oscillometric blood pressure measurement in anaesthetised dogs using ACVIM guidelines.

J Small Anim Pract. 2010 May 11;

Authors: Wernick M, Doherr M, Howard J, Francey T

Objectives: To evaluate high-definition and conventional oscillometry in comparison with direct blood pressure measurements in anaesthetised dogs. Methods: Eight simultaneous readings for systolic, diastolic and mean pressure were obtained directly and with each of two devices in nine anaesthetised dogs. Measurement procedure and validation were based on the 2007 ACVIM guidelines. Results: Sixty-three simultaneous readings were evaluated for each device and direct measurements. The mean differences (bias) to direct values were within 10 mmHg for both devices although bias for systolic and diastolic blood pressures was higher for Memodiagnostic. The standard deviations of differences (precision) were within 15 mmHg for Dinamap but exceeded for Memodiagnostic. Correlation coefficients were higher for Dinamap than Memodiagnostic but both failed to reach a correlation of 0.9. Over 50% of values lay within 10 mmHg of direct measures for both devices, but this percentage was greater for Dinamap than Memodiagnostic. Over 80% of values lay within 20 mmHg of direct measures for Dinamap but not for Memodiagnostic. Clinical Significance: Both devices failed to meet ACVIM guideline validation. However, Dinamap only failed with regards to correlation. Memodiagnostic failed on several requirements, and based on poor correlation, accuracy and precision, this device cannot be currently recommended for dogs under anaesthesia.

PMID: 20492450 [PubMed - as supplied by publisher]

]]>

Related Articles

< ![CDATA[

Proton pump inhibitors for prophylaxis of nosocomial upper gastrointestinal tract bleeding: effect of standardized guidelines on prescribing practice.

Arch Intern Med. 2010 May 10;170(9):779-83

Authors: Yachimski PS, Farrell EA, Hunt DP, Reid AE

BACKGROUND: Proton pump inhibitors (PPIs) are frequently prescribed for prophylaxis of nosocomial upper gastrointestinal tract bleeding. Some inpatients receiving PPIs may have no risk factors for nosocomial upper gastrointestinal tract bleeding, and PPIs may be continued unnecessarily at hospital discharge. We aimed to assess the effect of standardized guidelines on PPI prescribing practices. METHODS: Guidelines for PPI use were implemented on the medical service at a tertiary center. We reviewed PPI use among inpatient admissions during the month before implementation of guidelines and then prospectively evaluated PPI use among admissions during the month after implementation of guidelines. RESULTS: Among an overall cohort of 942 patients, 48% were prescribed PPIs while inpatients, and 41% were prescribed PPIs at hospital discharge. Univariate predictors of inpatient PPI use included age, length of hospital stay, history of gastroesophageal reflux disease or upper gastrointestinal tract bleeding, and outpatient PPI, aspirin, or glucocorticoid use. Among patients not on an outpatient regimen of PPIs at admission, implementation of guidelines resulted in lower rates of inpatient PPI use (27% before vs 16% after, P = .001) and PPI prescription at discharge (16% before vs 10% after, P = .03). CONCLUSION: Introduction of standardized guidelines resulted in lower rates of PPI use among a subset of inpatients and reduced the rate of PPI prescriptions at discharge.

PMID: 20458085 [PubMed - in process]

]]>

Related Articles

< ![CDATA[

Does the frequency of HIV and STI testing among MSM in primary care adhere with Australian guidelines?

Sex Transm Infect. 2010 May 10;

Authors: Guy R, Goller JL, Spelman T, El-Hayek C, Gold J, Lim M, Leslie D, Tee BK, Roth N, Anderson J, Fairley CK, Kaldor J, Hellard M

Objectives Australian guidelines recommend annual testing for HIV and sexually transmitted infections (STIs) for all men who have sex with men (MSM) and 3-6 monthly testing for those at higher risk as defined by behavioural criteria. We assessed HIV/STI re-testing rates among MSM attending primary care clinics. Methods We conducted a retrospective follow-up of HIV negative MSM tested for HIV or STIs (chlamydia or syphilis) at four primary care clinics in the 9-month period: April to December 2006. Re-testing rates for these infections were calculated over 18 months. Logistic regression was undertaken to identify predictors of guideline adherence. Results Of the MSM requiring annual HIV testing according to the guidelines, the re-testing rates at 1 y were 35% (762/2163). Among the higher risk MSM, 6-monthly HIV re-testing rates were 15% (283/1862). Within the subgroup who reported 11 or more male sexual partners within the past 6 months, HIV re-testing rates within 6 months were 19%. Independent predictors of HIV re-testing within 6 months in higher-risk MSM were reporting 11 or more male sexual partners in the last 6 months (AOR 3.1, 95% CI 1.8 to 4.8); being born overseas (AOR 2.0, 95% CI 1.2 to 3.4); and previous HIV testing more than 12 months earlier (AOR 3.3, 95% CI 1.9 to 5.5). Conclusion There is poor adherence to national guidelines that recommend regular re-testing of MSM for STIs, particularly among those at higher risk who require more frequent testing. Clinical strategies are urgently needed to encourage more frequent HIV/STI testing among MSM, especially in the higher risk subgroup.

PMID: 20460263 [PubMed - as supplied by publisher]

]]>

< ![CDATA[

A further survey of Australian ophthalmologist's diabetic retinopathy management: did practice adhere to NHMRC guidelines?

Clin Experiment Ophthalmol. 2010 May 10;

Authors: Yuen J, Clark A, Ng JQ, Morlet N, Keeffe J, Taylor HR, Preen DB

ABSTRACT Background: To compare the self-reported management of diabetic retinopathy by Australian ophthalmologists with the 1997 NHMRC guidelines. Method: Self reported cross-sectional survey of patterns of practice. Questionnaires were sent to all Australian ophthalmologists, comprising questions regarding professional details; diabetic retinopathy screening attitudes/practices; and specific hypothetical management scenarios. Data were analysed using Chi-square and adjusted logistic regression. Result: 480 of the 751 (64%) eligible Australian ophthalmologists participated. The majority (80%, n = 376) reported they consistently reviewed patient's glycaemic control, but only 55% and 41% regularly reviewed blood pressure and serum cholesterol control, respectively. Ophthalmologists generally adhered to NHMRC recommended screening intervals, although only 38% agreed with the guidelines relating to screening of pre-pubertal diabetic patients. Fluorescein angiogram was used more than recommended, especially for mild non-proliferative diabetic retinopathy where 45% of respondents used this investigation. Practice duration >15 years was associated with more regular fluorescein angiogram use (OR = 3.74; 95%CI: 2.53-5.53, p < 0.001). In the clinical scenarios where clinically significant macular oedema was concurrently present with cataract or proliferative diabetic retinopathy, >26% referred to retinal sub-specialists for management. 85% of the remaining ophthalmologists performed macular laser first. Respondents with practice duration >15 years were 7.8 times (p=0.001) more likely to perform cataract surgery first. Conclusion: Diabetic retinopathy management guidelines were generally well followed by Australian ophthalmologists. However, areas of practice variation existed including frequent use of fluorescein angiogram. Significant proportion of practitioners referred diabetic patients to retinal sub-specialists; who were more likely to adhere to guideline recommendations. Ophthalmologists with greater experience (>15years) were more likely to employ practices differing from NHMRC recommendations.

PMID: 20491799 [PubMed - as supplied by publisher]

]]>